Health Promotion Strategies in 4 PanAm Countries

By Pascale Leclair-Roberts

As the PanAm games are unravelling in Toronto, a sense of celebration and pride has taken the city. With all the victories and cultural festivities surrounding us, making it easy to be proud of the unity these games have brought to our side of the globe.

The health promotion field also has many things to celebrate. Many PanAm countries have committed to protecting and promoting the health of their countries, and have gone great lengths to do so. So in the spirit of PanAm games, here are four health promotion strategies among PanAmerican countries that are worth celebrating:

Mexico: Childhood Obesity Prevention Strategies

Mexico has the highest childhood obesity rate internationally as well as the fastest growth rate of obesity. Among children aged 5 – 11, it is estimated that 19.8% are overweight and 14.6% are obese. Among youth aged 12-19 years, it is estimated that 21.6% are overweight and 13.3% are obese.

Recognizing the crisis and urgency for action, the Mexican ministry of Health implemented in 2009 the by Prevención de la obesidad y las enfermedades crónicas asociadas: Bases para una política de Estado con énfasis en la alimentación (National Policy Plan to Prevent Obesity and Chronic Disease). Fifteen agencies across the Mexican government signed the agreement where 10 objectives were outlines in the efforts of reducing childhood obesity.

In addition, the Ministry launched in 2010 a campaign titled Muévete y Métete en Cintura (literally “Move and get yourself in shape”). The initiative encourages physical activity and nutritional diets, offering free activities and cooking classes to communities. In addition, as part of the campaign, Mexico City closes one or two large boulevards on weekends to offer citizens the opportunity to get out and bike, rollerblade, skate, participate in outdoor sport activities and dancing classes.

In western countries, anti-smoking strategies have been active since the mid-20th century and has succeeded to significantly reduce smoking among its populations. Unfortunately, in most PanAm developing countries, anti-smoking campaigns are few and far between. However, over the last ten years, Uruguay has become a leader in anti-smoking strategies among its Latin-American peers. In 2006, it became the first country in Latin America to ban smoking in enclosed public spaces. At the same time, it began graphic warnings of smoking-related consequences on the front and the back of cigarette packs, covering up to 80% of packs with these signs. In 2008, Uruguay put a ban on tobacco advertising, which was later passed as legislation in 2014, and included a ban on tobacco product display. In 2009, Uruguay also became the first country worldwide to ban differentiated branding, whereby all brands are packaged in a uniform case.

So far, Uruguay’s anti-smoking efforts have received great support from its population, both smokers and non-smokers. It has also led to successful declines in smoking prevalence, where between 2006 and 2011, male smoking prevalence rate declined from 39% to 29.7%, and females, 28% to 19%.

Since the 1980s, Brazil has invested a lot of time, effort and resources in offering universal health coverage to all its citizens. It has a decentralized, publicly funded strategy funded primarily through taxes. However, Brazil is also home to the fifth largest population and the seventh largest economy in the world, making it challenging to ensure that all citizens, including those in remote towns, receive access to health care and health education. In the 1990s, recognizing this challenge, public health officials developed a more community-based approach to providing health care and education. Basing it on a maternal and child health program in the northern state of Ceara that relied on community health teams to deliver care, the Family Health Program was born, later renamed the Family Health Strategy (FHS). The strategy deploys an interdisciplinary team of agents (made up of primary care practitioners, public health specialist, health promotion agents, among many others) that deliver health care and public health services to an assigned micro-area serving up to 1000 households each, with no overlap or gap between areas. Community agents are made up of local citizens hired through the Family Health Strategy.

Community agents in these teams work with individual homes, schools and other community-based organization to promote and educate populations on healthy lifestyles, covering a wide-array of topics such as sexual health, maternal health, nutrition, physical activity, sanitation, and common communicable/non-communicable diseases.

While financial and resource challenges remain in providing optimal health services to all citizens, the FHS and its community agents have played a significant role in reducing inequalities in access to health care and other health services. About 70% of Brazil’s population receives health services through FHS teams, and the remainder are those who can afford to pay for private health services.

Belize has the 3rd greatest prevalence of HIV/AIDS in the Carribean, and the highest prevalence in Central America. A particular problem Belize has is the high prevalence of youth with HIV, where AIDS is the leading cause of death among those aged 15 to 49. In 2004, Belize’s Red Cross adopted the “Together We Can” program, an HIV Peer Education program. The program has been running in several countries in the Carribean since the mid-1990s, and when implemented in Belize, it was reviewed and tailored to the unique cultural and societal characteristics of the Belizean population. In particular, they targeted youth and attempted to break down social stigma and barriers using education and communication. The program trains Peer Educators that then in turn teach and train persons on life skills and healthy choices to combat HIV transmission. The program has also significantly increased public awareness though ad and media campaigns

Together We Can has been a great success in Belize, creating a network of peer supporters and continuous peer teaching and training on HIV transmission and life choices. Between 2008 and 2009, it was estimated that transmission rate fell by 14%. There has also been increase in treatment and coverage rate, where it increased from 50% in 2008 to 62% in 2009.